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Billing code 87183 · Lab & pathology

87183 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $30.95 for 87183 across 20 states, from $8.77 in Kansas to $47.80 in Illinois.

Data as of Oct 5, 202620 statesEvery rate links to its official source

States publishing
20
National median
$30.95units vary by state
Lowest
$8.77Kansas
Highest
$47.80Illinois
Answer

What does Medicaid pay for 87183?

20 state Medicaid programs publish a fee-for-service rate for 87183. The national median is $30.95 (units differ between states). Illinois pays the most, $47.80, and Kansas the least, $8.77, a 5.5x spread.

State ranking

87183 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 20 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Illinois Source · since 2026-01-01$47.80——Plans negotiate; applies out of network—
2Arizona Source · since 2026-10-01$35.09——Plans negotiate; applies out of network—
3California Source · since 2026-10-01$35.09——Plans negotiate; applies out of network—
10West Virginia Source · since 2026-01-01$31.58——Plans negotiate; applies out of network—
11Idaho Source · since 2026-07-01$30.32——Not classified—
12Michigan Source · since 2026-01-01$29.05——Plans negotiate; applies out of network—
19Rhode Island Source · since 2026-01-01$21.05——Plans negotiate; applies out of network—
20Kansas Source · since 2026-01-01$8.77——Not classified—
See all 20 states for 87183 — start free

12 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 87183 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 87183, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 5 of the 20 states list more than one rate for 87183, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 20 schedules prints a separate unit for 87183, so each amount is a flat payment for one service as the code defines it.
  • Per hour. 87183 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 87183, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 87183 rates differ between states

Published rates for 87183 run from $8.77 in Kansas to $47.80 in Illinois, a 5.5x gap in the same unit. Half the states pay more than the median of $30.95 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.
  • Pathology services with an interpretation have professional and technical components that states price separately.

Timing matters too. 20 states set the current rate for 87183 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 87183

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 87183, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 14 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (14 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Illinois managed care.

Billing

Units and billing for 87183

87183 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests. Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 87183?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $30.95. Illinois pays the most ($47.80) and Kansas the least ($8.77).

Which state pays the highest Medicaid rate for 87183?

Illinois, at $47.80, effective 2026-01-01.

Which state pays the lowest Medicaid rate for 87183?

Kansas, at $8.77, effective 2026-01-01.

What unit is 87183 billed in?

None of the 20 schedules prints a separate unit for 87183, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for 87183?

Not necessarily. In 14 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.